Inequalities in esophageal cancer mortality in Brazil: Temporal trends and projections

Abstract

The main objective of the study was to analyze the effect of age, period and birth cohort on esophageal cancer mortality in Brazil and its geographic regions, per sex. An ecological study is presented herein, which evaluated the deaths by esophageal cancer and the distribution, per geographic region. Poisson Regression was utilized to calculate the effects of age, period and birth cohort, and projections were made with the statistical software R, using the age-period-cohort model. Projection of data covered the period 2015–2029. Regarding the geographic regions of Brazil, a decrease was verified, throughout time, for the mortality rates of the South and Southeast regions, for men and women. For the North, Northeast and Midwest regions, an increase was evidenced in mortality rates, mainly for men, after the 2000's. Regarding the projections, a progressive increase of mortality rates was verified for the Northeast and North regions. Divergences evidenced for observed and projected esophageal cancer mortality rates revealed inequalities among the geographic regions of Brazil.

Mortality by colon, lung, esophagus, prostate, cervix and breast cancers in Brazilian capitals, 2000-2015: a multilevel analysis

“…Colon, esophageal and lung cancers mortality rates are consistently higher in men than in women [6][7][8]. Our results also pointed statistical difference in mortality by gender for colon, lung and esophageal cancers.…”

Analysis of the effects of the age-period-birth cohort on cervical cancer mortality in the Brazilian Northeast

“…With regard to cervical cancer mortality, improvements in the quality and coverage of Mortality Information System may increase deaths from this cancer as there is a reduction in records classified as an ill-defined cause, incomplete diagnosis of general cancer, diagnosis of incomplete cancer for female genital tract, unspecified portion of uterus cancer. Thus, the observed increase in mortality rates after expanding access to health services may correlate with better quality of death information rather than with increased incidence rates and reduced survival [20,[39][40][41].…”

“…We believe that the differences observed in the temporal trend in corrected and uncorrected data are possibly related to improvements in the quality of information presented by death records in Brazilian states in the 2000s [19,[39][40][41]. Due to the expansion of access to health services after the implementation of the Unified Health System (Sistema Ú nico de Saúde) [19,[39][40][41]. Therefore, women who died in the 2000s, especially those from younger cohorts, are more likely to have their underlying cause of death ranked correctly when compared to women who died in the 1980s and 1990s.…”

“…Therefore, women who died in the 2000s, especially those from younger cohorts, are more likely to have their underlying cause of death ranked correctly when compared to women who died in the 1980s and 1990s. Thus, without the use of indirect correction techniques, we could raise wrong assumptions about the effects of age, period, and cohort on cervical cancer mortality [19,[39][40][41].…”

“…The quality of information and coverage of SIM/DATASUS death records has improved in recent decades; However, there are significant disparities between regions according to socioeconomic development. In fact, between the 1990s and 2000s, there was a significant improvement in the information coverage and quality for all geographic regions of Brazil [19,[37][38][39][40]. However, states in the northern and northeastern regions with the lowest socioeconomic development still present significant problems in their Mortality Information Systems [37][38][39][40].…”